Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial

Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that co...

Full description

Saved in:
Bibliographic Details
Published inCritical care medicine Vol. 40; no. 3; p. 787
Main Authors Blewer, Audrey L, Leary, Marion, Esposito, Emily C, Gonzalez, Mariana, Riegel, Barbara, Bobrow, Bentley J, Abella, Benjamin S
Format Journal Article
LanguageEnglish
Published United States 01.03.2012
Subjects
Online AccessGet more information
ISSN1530-0293
DOI10.1097/CCM.0b013e318236f2ca

Cover

Loading…
Abstract Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths). Prospective, multicenter randomized study. Three academic medical center inpatient wards. Adult family members or friends (≥ 18 yrs old) of inpatients admitted with cardiac-related diagnoses. In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes. Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments. Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or "secondary training." Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves "very comfortable" with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08). Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge. URL: http://clinicaltrials.gov. Unique identifier: NCT01260441.
AbstractList Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although little is known about layperson preferences for training in continuous chest compression cardiopulmonary resuscitation. We hypothesized that continuous chest compression cardiopulmonary resuscitation education would lead to greater trainee confidence and would encourage wider dissemination of cardiopulmonary resuscitation skills compared to standard cardiopulmonary resuscitation training (30 compressions: two breaths). Prospective, multicenter randomized study. Three academic medical center inpatient wards. Adult family members or friends (≥ 18 yrs old) of inpatients admitted with cardiac-related diagnoses. In a multicenter randomized trial, family members of hospitalized patients were trained via the educational method of video self-instruction. Subjects were randomized to continuous chest compression cardiopulmonary resuscitation or standard cardiopulmonary resuscitation educational modes. Cardiopulmonary resuscitation performance data were collected using a cardiopulmonary resuscitation skill-reporting manikin. Trainee perspectives and secondary training rates were assessed through mixed qualitative and quantitative survey instruments. Chest compression performance was similar in both groups. The trainees in the continuous chest compression cardiopulmonary resuscitation group were significantly more likely to express a desire to share their training kit with others (152 of 207 [73%] vs. 133 of 199 [67%], p = .03). Subjects were contacted 1 month after initial enrollment to assess actual sharing, or "secondary training." Kits were shared with 2.0 ± 3.4 additional family members in the continuous chest compression cardiopulmonary resuscitation group vs. 1.2 ± 2.2 in the standard cardiopulmonary resuscitation group (p = .03). As a secondary result, trainees in the continuous chest compression cardiopulmonary resuscitation group were more likely to rate themselves "very comfortable" with the idea of using cardiopulmonary resuscitation skills in actual events than the standard cardiopulmonary resuscitation trainees (71 of 207 [34%] vs. 57 of 199 [28%], p = .08). Continuous chest compression cardiopulmonary resuscitation education resulted in a statistically significant increase in secondary training. This work suggests that implementation of video self-instruction training programs using continuous chest compression cardiopulmonary resuscitation may confer broader dissemination of life-saving skills and may promote rescuer comfort with newly acquired cardiopulmonary resuscitation knowledge. URL: http://clinicaltrials.gov. Unique identifier: NCT01260441.
Author Leary, Marion
Riegel, Barbara
Bobrow, Bentley J
Esposito, Emily C
Abella, Benjamin S
Gonzalez, Mariana
Blewer, Audrey L
Author_xml – sequence: 1
  givenname: Audrey L
  surname: Blewer
  fullname: Blewer, Audrey L
  organization: Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA, USA
– sequence: 2
  givenname: Marion
  surname: Leary
  fullname: Leary, Marion
– sequence: 3
  givenname: Emily C
  surname: Esposito
  fullname: Esposito, Emily C
– sequence: 4
  givenname: Mariana
  surname: Gonzalez
  fullname: Gonzalez, Mariana
– sequence: 5
  givenname: Barbara
  surname: Riegel
  fullname: Riegel, Barbara
– sequence: 6
  givenname: Bentley J
  surname: Bobrow
  fullname: Bobrow, Bentley J
– sequence: 7
  givenname: Benjamin S
  surname: Abella
  fullname: Abella, Benjamin S
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22080629$$D View this record in MEDLINE/PubMed
BookMark eNo1kEtOxDAMhiMEYh5wA4RygUIeTZuwQxUvaRAbWI_S1GGC2qRK2gVciwuSAWblX_7sT5ZX6NgHDwhdUHJFiaqvm-b5irSEcuBUMl5ZZvQRWlLBSUGY4gu0SumDEFqKmp-iBWNEkoqpJfpugp-cn8OcsNlBmrAJwxghJRc8Njp2LoxzPwSv4yfO_TkZN-lpT6eonXf-HY8xDGGCtOdmhogT9LYwwVvXgTeAte-w8yaCTtBlmlG39x0MN1jjXUhjNvdF-zsU804Y3FeOeXqKoe9znKLT_Rk6sbpPcP5f1-jt_u61eSw2Lw9Pze2mMCWvWCFqIkVJjFYcZEeElLSztRClEFZRa8FYsJorDbJVmpeSclqLtiTKVIq1nK3R5Z93nNsBuu0Y3ZCv3h6-x34A-mx55g
CitedBy_id crossref_primary_10_1016_j_ijnurstu_2019_103451
crossref_primary_10_1161_CIR_0000000000000903
crossref_primary_10_1016_j_resuscitation_2020_04_026
crossref_primary_10_1016_j_resplu_2021_100177
crossref_primary_10_1161_CIR_0000000000000268
crossref_primary_10_1016_j_emc_2023_03_001
crossref_primary_10_1177_1474515117721010
crossref_primary_10_1017_cem_2015_113
crossref_primary_10_1161_CIR_0000000000000744
crossref_primary_10_2147_RMHP_S259956
crossref_primary_10_3389_fped_2022_1000544
crossref_primary_10_1016_j_ecns_2016_02_013
crossref_primary_10_1016_j_resuscitation_2016_04_028
crossref_primary_10_1542_peds_2022_060463
crossref_primary_10_1016_j_ajem_2012_09_028
crossref_primary_10_1161_CIR_0b013e318288b4dd
crossref_primary_10_1016_j_resuscitation_2015_07_038
crossref_primary_10_1016_j_resuscitation_2015_07_032
crossref_primary_10_1097_MCC_0000000000000296
crossref_primary_10_1186_s13049_019_0690_7
crossref_primary_10_1186_1757_7241_21_36
crossref_primary_10_1097_MCC_0b013e328360ac76
crossref_primary_10_1111_1742_6723_13339
crossref_primary_10_3349_ymj_2016_57_2_505
crossref_primary_10_1002_jja2_12922
crossref_primary_10_1016_S0140_6736_18_30472_0
crossref_primary_10_5847_wjem_j_1920_8642_2015_04_004
crossref_primary_10_1186_s12245_020_00287_9
crossref_primary_10_1016_j_resuscitation_2014_08_032
crossref_primary_10_1016_j_resuscitation_2015_12_016
crossref_primary_10_1111_josh_12634
crossref_primary_10_1016_j_resuscitation_2019_05_040
crossref_primary_10_1016_j_resuscitation_2022_10_005
crossref_primary_10_1161_CIRCOUTCOMES_116_002493
crossref_primary_10_1136_bmjopen_2021_058827
crossref_primary_10_1109_TETC_2019_2925777
crossref_primary_10_5847_wjem_j_1920_8642_2017_01_002
crossref_primary_10_1080_2331205X_2017_1334408
crossref_primary_10_1161_CIR_0000000000000277
crossref_primary_10_1016_j_resuscitation_2015_07_046
crossref_primary_10_1161_CIR_0000000000001054
crossref_primary_10_7759_cureus_8647
crossref_primary_10_1161_CIR_0000000000001095
crossref_primary_10_1007_s10049_015_0092_y
crossref_primary_10_1016_j_ehj_2014_11_001
crossref_primary_10_1007_s10049_015_0097_6
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
DOI 10.1097/CCM.0b013e318236f2ca
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
DatabaseTitleList MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Medicine
EISSN 1530-0293
ExternalDocumentID 22080629
Genre Multicenter Study
Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Journal Article
GrantInformation_xml – fundername: NHLBI NIH HHS
  grantid: R18 HL107217
GroupedDBID ---
.-D
.3C
.55
.GJ
.XZ
.Z2
01R
0R~
1J1
354
3O-
40H
4Q1
4Q2
4Q3
53G
5GY
5RE
5VS
6J9
6PF
71W
77Y
7O~
AAAAV
AAAXR
AAGIX
AAHPQ
AAIQE
AAJCS
AAMOA
AAMTA
AAQKA
AAQQT
AARTV
AASCR
AASOK
AASXQ
AAUEB
AAWTL
AAXQO
AAYEP
ABASU
ABBUW
ABDIG
ABJNI
ABOCM
ABPPZ
ABPXF
ABVCZ
ABXVJ
ABXYN
ABZAD
ABZZY
ACCJW
ACDDN
ACDOF
ACEWG
ACGFO
ACGFS
ACILI
ACLDA
ACOAL
ACWDW
ACWRI
ACXJB
ACXNZ
ACZKN
ADFPA
ADGGA
ADHPY
ADNKB
AE3
AE6
AEBDS
AEETU
AENEX
AFBFQ
AFDTB
AFEXH
AFFNX
AFMBP
AFNMH
AFSOK
AFUWQ
AGINI
AHOMT
AHQNM
AHQVU
AHRYX
AHVBC
AI.
AIJEX
AINUH
AJCLO
AJIOK
AJNWD
AJNYG
AJZMW
AKCTQ
AKULP
ALKUP
ALMA_UNASSIGNED_HOLDINGS
ALMTX
AMJPA
AMKUR
AMNEI
AOHHW
AOQMC
BOYCO
BQLVK
BS7
BYPQX
C45
CGR
CS3
CUY
CVF
DIWNM
DU5
DUNZO
E.X
EBS
ECM
EEVPB
EIF
EJD
ERAAH
EX3
F2K
F2L
F2M
F2N
F5P
FCALG
FL-
FW0
GNXGY
GQDEL
H0~
HLJTE
HZ~
IKREB
IKYAY
IN~
IPNFZ
J5H
JF9
JG8
JK3
JK8
K-A
K-F
K8S
KD2
KMI
L-C
L7B
M18
N4W
N9A
NEJ
NPM
N~7
N~B
N~M
O9-
OAG
OAH
OB4
OBH
OCUKA
ODA
ODMTH
ODZKP
OHH
OHT
OHYEH
OL1
OLB
OLG
OLH
OLU
OLV
OLY
OLZ
ONV
OPUJH
ORVUJ
OUVQU
OVD
OVDNE
OVIDH
OVLEI
OVOZU
OWBYB
OWU
OWV
OWW
OWX
OWY
OWZ
OXXIT
P-K
P2P
PONUX
R58
RIG
RLZ
S4R
S4S
T8P
TEORI
TSPGW
V2I
VH1
VVN
W3M
WOQ
WOW
X3V
X3W
X7M
XXN
XYM
YFH
YOC
YOJ
ZCG
ZFV
ZGI
ZXP
ZY1
ZZMQN
~9M
ID FETCH-LOGICAL-c4362-5708540ca93e8d05881df755455f91ffecfefa39ae8b9a34813175b409c692b32
IngestDate Mon Jul 21 05:23:48 EDT 2025
IsPeerReviewed true
IsScholarly true
Issue 3
Language English
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c4362-5708540ca93e8d05881df755455f91ffecfefa39ae8b9a34813175b409c692b32
PMID 22080629
ParticipantIDs pubmed_primary_22080629
PublicationCentury 2000
PublicationDate 2012-March
PublicationDateYYYYMMDD 2012-03-01
PublicationDate_xml – month: 03
  year: 2012
  text: 2012-March
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Critical care medicine
PublicationTitleAlternate Crit Care Med
PublicationYear 2012
References 7726702 - Arch Intern Med. 1995 May 8;155(9):938-43
17998457 - Circulation. 2007 Nov 27;116(22):2525-30
11719126 - Resuscitation. 2001 Jul;50(1):27-37
10694169 - Resuscitation. 2000 Jan;43(2):101-10
9189184 - Acad Emerg Med. 1997 Jun;4(6):540-4
17442479 - Resuscitation. 2007 Sep;74(3):476-86
2912416 - Arch Intern Med. 1989 Jan;149(1):61-4
20519751 - Hong Kong Med J. 2010 Jun;16(3):165-70
16154678 - Resuscitation. 2005 Oct;67(1):31-43
11008994 - Crit Care Med. 2000 Sep;28(9):3289-95
20956217 - Circulation. 2010 Nov 2;122(18 Suppl 3):S640-56
20951422 - Lancet. 2010 Nov 6;376(9752):1552-7
10321843 - Resuscitation. 1999 Jan;40(1):11-9
10825619 - Resuscitation. 2000 May;44(3):187-93
12909379 - Resuscitation. 2003 Aug;58(2):171-6
20123673 - Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):63-81
20370759 - Acad Emerg Med. 2010 Mar;17(3):269-75
20202679 - Lancet. 2010 Apr 17;375(9723):1347-54
20924010 - JAMA. 2010 Oct 6;304(13):1447-54
21916007 - J Hosp Med. 2011 Sep;6(7):428-32
18071077 - Circulation. 2007 Dec 18;116(25):2908-12
18812533 - JAMA. 2008 Sep 24;300(12):1423-31
9506495 - Ann Emerg Med. 1998 Mar;31(3):364-9
10824072 - N Engl J Med. 2000 May 25;342(21):1546-53
20956220 - Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84
21093974 - Resuscitation. 2011 Jan;82(1):3-9
11382527 - Resuscitation. 2001 May;49(2):201-5
18502559 - Resuscitation. 2008 Aug;78(2):119-26
21273279 - BMJ. 2011;342:c7106
22343848 - Crit Care Med. 2012 Mar;40(3):992-3
21146914 - Resuscitation. 2011 Mar;82(3):319-25
17368153 - Lancet. 2007 Mar 17;369(9565):920-6
17724257 - Circulation. 2007 Sep 18;116(12):1380-5
15081180 - Resuscitation. 2004 Apr;61(1):41-7
11705826 - Circulation. 2001 Nov 13;104(20):2465-70
21386066 - Circ Cardiovasc Qual Outcomes. 2011 Mar;4(2):220-6
18071072 - Circulation. 2007 Dec 18;116(25):2900-7
18195177 - Circulation. 2008 Feb 5;117(5):704-9
18226319 - CJEM. 2008 Jan;10(1):51-65
References_xml – reference: 10825619 - Resuscitation. 2000 May;44(3):187-93
– reference: 20924010 - JAMA. 2010 Oct 6;304(13):1447-54
– reference: 17998457 - Circulation. 2007 Nov 27;116(22):2525-30
– reference: 11719126 - Resuscitation. 2001 Jul;50(1):27-37
– reference: 20951422 - Lancet. 2010 Nov 6;376(9752):1552-7
– reference: 20370759 - Acad Emerg Med. 2010 Mar;17(3):269-75
– reference: 11008994 - Crit Care Med. 2000 Sep;28(9):3289-95
– reference: 9506495 - Ann Emerg Med. 1998 Mar;31(3):364-9
– reference: 12909379 - Resuscitation. 2003 Aug;58(2):171-6
– reference: 17368153 - Lancet. 2007 Mar 17;369(9565):920-6
– reference: 11382527 - Resuscitation. 2001 May;49(2):201-5
– reference: 10321843 - Resuscitation. 1999 Jan;40(1):11-9
– reference: 16154678 - Resuscitation. 2005 Oct;67(1):31-43
– reference: 18071077 - Circulation. 2007 Dec 18;116(25):2908-12
– reference: 20202679 - Lancet. 2010 Apr 17;375(9723):1347-54
– reference: 22343848 - Crit Care Med. 2012 Mar;40(3):992-3
– reference: 10824072 - N Engl J Med. 2000 May 25;342(21):1546-53
– reference: 15081180 - Resuscitation. 2004 Apr;61(1):41-7
– reference: 18812533 - JAMA. 2008 Sep 24;300(12):1423-31
– reference: 20123673 - Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):63-81
– reference: 20956220 - Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84
– reference: 10694169 - Resuscitation. 2000 Jan;43(2):101-10
– reference: 2912416 - Arch Intern Med. 1989 Jan;149(1):61-4
– reference: 11705826 - Circulation. 2001 Nov 13;104(20):2465-70
– reference: 18195177 - Circulation. 2008 Feb 5;117(5):704-9
– reference: 21093974 - Resuscitation. 2011 Jan;82(1):3-9
– reference: 7726702 - Arch Intern Med. 1995 May 8;155(9):938-43
– reference: 21916007 - J Hosp Med. 2011 Sep;6(7):428-32
– reference: 18071072 - Circulation. 2007 Dec 18;116(25):2900-7
– reference: 17724257 - Circulation. 2007 Sep 18;116(12):1380-5
– reference: 20519751 - Hong Kong Med J. 2010 Jun;16(3):165-70
– reference: 20956217 - Circulation. 2010 Nov 2;122(18 Suppl 3):S640-56
– reference: 18226319 - CJEM. 2008 Jan;10(1):51-65
– reference: 9189184 - Acad Emerg Med. 1997 Jun;4(6):540-4
– reference: 21386066 - Circ Cardiovasc Qual Outcomes. 2011 Mar;4(2):220-6
– reference: 17442479 - Resuscitation. 2007 Sep;74(3):476-86
– reference: 21273279 - BMJ. 2011;342:c7106
– reference: 18502559 - Resuscitation. 2008 Aug;78(2):119-26
– reference: 21146914 - Resuscitation. 2011 Mar;82(3):319-25
SSID ssj0014573
Score 2.263517
Snippet Recent work suggests that delivery of continuous chest compression cardiopulmonary resuscitation is an acceptable layperson resuscitation strategy, although...
SourceID pubmed
SourceType Index Database
StartPage 787
SubjectTerms Cardiopulmonary Resuscitation - education
Cardiopulmonary Resuscitation - methods
Education - methods
Female
Hospitals
Humans
Male
Middle Aged
Prospective Studies
Self Concept
Single-Blind Method
Title Continuous chest compression cardiopulmonary resuscitation training promotes rescuer self-confidence and increased secondary training: a hospital-based randomized controlled trial
URI https://www.ncbi.nlm.nih.gov/pubmed/22080629
Volume 40
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LT9wwELYWkKpeEKUPKG01B26VaYidF7cKbYuQlhNI3JCT2OpKSxZpiRD7t_qT-kc640cSFlq1XKLI2bWizCd7ZvzNfIztC6kRRSrlZVFnXB7Ghuc6inhe5TiS5yI1dKI7OUtPLuTpZXI5Gv0asJba2_KgWj5ZV_Icq-IY2pWqZP_Dst2kOID3aF-8ooXx-k82ptZS06YlFqvVvbIEcUdsbajndD0leS58HaLG4XiL-51nFwZpCCJoobU0nR4sqpZ6O-uZ4RglGyc36tszkXO5QOd0QQF0TfOFGVy59A-vP8JL-zPcAev59XSp60CGn-GtlQgZusOd0IIloD0655_pOy-23dYIuc9dopq6wt77UqMBkWDsOGg2-zu2iZsuB_x93ixxL1yGPymnGh4SHsQcCYyvAx0W6YhHsVNWDKu4a_rk0SoGS3LmNvRHW4VvQXw86XPBMSIzdgypAXpuri184hid69SlZ_7-dKWBd3i0xtYwlCFtVkoo-YMumWQiVHQW2ZenXof6VfspVmIf6wOdb7FNH7zAV4fEV2ykm232YuLN9pr97AEJFpAwACSsABIeABICnCAAEjwgYQWQgNCCDpDQAbKb4QgUPIQj9HCEHo5g4fiGXXwbnx-fcK8KwitJJX5JhlGCjCpVCJ3XUZJjxGUy9IqTxBSHRIIy2ihRKI2rjaI6c3KRSxkVVVrEpYjfsvVm3ugdBrXA3V1JobRMZFomKhMY_aO3lkuti0zssnfuc1_duNYvV8EQ7__4ZI-97EH7gW0YXGv0R3Rcb8tP1vS_Abk9paE
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Continuous+chest+compression+cardiopulmonary+resuscitation+training+promotes+rescuer+self-confidence+and+increased+secondary+training%3A+a+hospital-based+randomized+controlled+trial&rft.jtitle=Critical+care+medicine&rft.au=Blewer%2C+Audrey+L&rft.au=Leary%2C+Marion&rft.au=Esposito%2C+Emily+C&rft.au=Gonzalez%2C+Mariana&rft.date=2012-03-01&rft.eissn=1530-0293&rft.volume=40&rft.issue=3&rft.spage=787&rft_id=info:doi/10.1097%2FCCM.0b013e318236f2ca&rft_id=info%3Apmid%2F22080629&rft_id=info%3Apmid%2F22080629&rft.externalDocID=22080629